So you’ve decided you might like to give MDMA (Molly, ecstacy) a try. You’ve found some pills and tested them. But what does MDMA feel like? How much MDMA should you take? Is this a recreational experiment, a quest for personal growth? Time to make some choices and preparations. (“Rolling” is slang for being high on MDMA. The origins of the expression are not known, but the explanation I like best is that “rolling” describes the effortless energy and inner strength of the MDMA state…rolling along on sheer momentum.)

How much MDMA (Molly, ecstasy) should I take? What’s a normal dose of MDMA?

MAPS pioneering therapy work uses a standard dose of 120 mg. For most people, a ‘normal’ dose is likely to be in the 80-160 mg range. But, it depends on the person. A very large, athletic man may not feel much at all from 80 mg, while a small person might find 160 mg far too intense for comfort. If the drug is new to you, start with a lower dose and see how you react to it. You can always take more, but there’s no way to un-take that pill you swallowed an hour ago, so start out a bit on the low side. (Some people find that they’re happy with as little as 50 mg, while some reach fairly massive doses (such as 250 mg+) before they get the effect they want. Both cases are unusual, though; most people will prefer something closer to that 120 mg that MAPS is using.)

How long does it take MDMA (Molly, ecstasy) to kick in?

MDMA usually takes effect in about 30-45 minutes when swallowed. However, some people will start to feel high in less time, and in some cases (for instance, if you’ve taken the MDMA after a meal) it could take an hour or more to kick in. Snorted MDMA can take effect much more quickly, and injecting (which I strongly advise against) is almost instant. The drug can start to affect your judgement and attention span before you feel particularly ‘high’, so you shouldn’t drive or do other potentially dangerous things after taking a dose of MDMA.

How long does the MDMA (Molly, ecstasy) high last?

Depending on the person and the dosage taken, most people will feel truly ‘high’ for around 3-5 hours after the MDMA takes effect. But that doesn’t mean you’re entirely sober after that time period either! Avoid driving or other activities that require mental sharpness until you’ve had a good night’s sleep. MDMA can continue to have lingering effects on your mental state for a day or two.

How often can I use MDMA (Molly, ecstasy)?

It depends on a lot of things (including your genetics), but generally you shouldn’t use MDMA more than once a month at most (and even that is too often for some people.) The reason is that getting high stresses your brain, a bit like running a marathon stresses your body. It takes time for it to get completely back to normal. If you keep hitting your brain with more and more MDMA without enough recovery time, you can end up with problems with memory, concentration, anxiety, depression, etc.

After ‘is it safe’, by far the most common question people have is what an MDMA experience feels like. Strangely, this is a hard question for most users to really answer, because the effects are subtle and often personal in nature. The famous Dr. Shulgin describes MDMA this way:

“(with 100 mg) MDMA intrigued me because everyone I asked who had used it answered the question, ‘What’s it like?’ in the same way: ‘I don’t know.’ ‘What happened?’ ‘Nothing.’ And now I understand those answers. I too think nothing happened. But something seemed changed.”

If you’re a psychiatrist, it might be meaningful for me to say that MDMA produces a dissolution of neurotic fear, emotional openness, and euphoria with hyperactivity. But that doesn’t really capture the feeling.

• MDMA doesn’t ‘make you stupid’ the way a lot of alcohol does. (People who are trying MDMA for the first time are often amazed how perfectly normal and ‘themselves’ they feel.)

What it does do:

• MDMA produces relaxation, energy, and a sense of peace and joy. It’s a wonderful drug to hang out with friends and family on (but sooner or later they’ll notice you aren’t sober, so use with people who won’t mind.)

• MDMA has a strong stimulant effect. Most commonly, this manifests itself in rapid (but coherent) talking and a drive to be physically active. (Many people at raves have reported feeling compelled to dance when the drug took effect.)

• It is intoxicating–you will be somewhat less able to deal with unforeseen problems (you certainly don’t want to drive while high.)

• MDMA enhances appreciation of music, vision, touch and taste. (Massages are popular with people on MDMA.) This is not an amplification of your senses per se; rather, your brain is enjoying sensations much more.

• MDMA can relieve pain (serotonin is involved in pain control.) In some cases this effect is profound: Terminally ill people suffering terrible chronic pain have reported complete temporary relief during an MDMA experience.

• People on MDMA are almost incapable of aggression or hostility (although violence isn’t impossible if the user feels it’s necessary to protect themselves or others.)

• People on MDMA are “overly focused”…they’re living fully in the moment, and as a result are easily distracted (which is the main reason you don’t want to try to drive.)

OK, that’s interesting…but what does it FEEL like?

At its best? It feels like joy. Like standing in the presence of God and knowing you are loved without reservation. It feels the way you haven’t felt since you were a small child, absolutely alive, absolutely in the moment, able to feel and experience and share with others without fear or hesitation. It is the most perfect moment of the most perfect day of your life, when trouble was nothing but a memory and the possibilities rolled on forever. It is the achievement of the inner peace the religions try to sell but rarely deliver. At its best, MDMA is one of the finest, purest, most profound experiences life has to offer.

If that sounds a little intense, it is. But…that’s not necessarily the typical MDMA experience. Producing such peak experiences depends on the dosage taken, the environment, and the person’s mental and physical state going in. At lower doses, etc. the experience is much milder (but still often remarkable.) How far you want to take it is up to you. At low doses, a person on MDMA can wander about public places, strike up conversations, etc. and not be thought of as ‘odd’ or particularly noticed. At low doses, you just feel unusually cheerful, sociable and energetic, as though you were extraordinarily well rested and relaxed. MDMA is fairly flexible in what it can do. If you seek an at-one-with-the-universe religious experience, that can be achieved…but it’s also a perfectly nice and controllable recreational drug for going out on the town. Like alcohol, it’s not a matter of simply being completely drunk vs. completely sober…there is a large range of possibilities in between. You pick your dose, you pick your environment, you pick what you want to try to get out of it.

Although simple recreation is the most popular use, MDMA first became popular because of its use in therapy. Under the influence of MDMA, many people have been able to overcome fears, let go of past traumas, and examine and come to terms with aspects of their own lives. Currently, the US government has given approval for human experiments with MDMA in the treatment of post-traumatic stress disorder (PTSD in soldiers as a result of combat trauma (being wounded, seeing friends die, etc.) Such cases used to be called “shell shock.”) For more information or to contribute to this research, visit MAPS.

There’s got to be a down side. What can go wrong?

For medical risks, visit the Science section and Getting Ready. There are also a few psychological issues to be aware of.

The most unpleasant potential psychological event while on MDMA is a “bad trip.” Such events are unusual, and appear to be caused by taking too much, being in a threatening environment, or trying to fight and suppress the drug’s effects. I describe them as a “panic”, not in the sense of running around screaming, but in the sense of an overwhelming fear that things are slipping beyond your control. An MDMA panic/anxiety attack usually consists of extreme emotional discomfort and a fear that something terrible is happening or about to happen. It’s not medically dangerous, but feeling like you might be going to die is a miserable experience either way. If a panic occurs, you’ll just have to ride it out. Try to relax, and remind yourself that you are physically fine and will soon be back to normal. If possible, talk to somebody you trust. Once it passes you can still enjoy the rest of time until the drug wears off.

Avoiding a ‘panic’ is fairly easy. First, use MDMA (or any drug, for that matter) in places and around people where you feel safe and comfortable. Second, don’t go wild with how much you take…know your limits. And finally (and perhaps most importantly) be at peace with the idea of altering your state of mind. When the world starts to look a little different and you start to feel a little different, your response should be “cool, the drug is kicking in”, not “oh my god what’s happening to me?” Once you introduce a drug into your system, it will run its course, one way or the other. Address any major reservations you have before dosing. After you’ve swallowed a pill is not the time for second thoughts…at that point you’re committed.

These ‘panic’ states are most likely to occur during the onset or peak of drug effects, but may also occur later on if you are faced with a threatening situation (threat of violence, etc.)

Another issue with MDMA use is that, as with any intoxicating drug, you might do something that seemed like a good idea at the time but which you might regret the next day. Maybe you were a little more open with your feelings than you planned. Maybe you had sex with somebody that by the light of the day after wasn’t necessarily a good match for you. It’s one more reason to either use in a public setting (such as a rave) where you can’t really get yourself in trouble, or a private setting with people you really trust.

MDMA doesn’t force people to tell the truth…you can easily lie while high if you think it’s appropriate. However, you’ll be much more open about things that you really wanted to talk about (but wouldn’t normally feel comfortable bringing up.) You can just go dancing or be by yourself and never have the issue of ‘saying too much’ come up…but frankly, the sense of interpersonal trust and compassion is part of the charm of a MDMA experience.

Because it temporarily alters your brain chemistry (like any psychoactive drug) MDMA may trigger or worsen psychiatric problems in vulnerable individuals. In particular, the risk of depression/anxiety during the hangover period may be particularly high for people who were already suffering from a psychiatric problem. This risk can be reduced with 5-HTP, a nutritional supplement that helps replace serotonin.

What are some MDMA side effects?

There are a broad range of side affects, from the amusing to the genuinely troublesome. These side effects are all dose-dependant (the more you took the more likely to occur/severe the side effect may be):

• Pupil dilation. Always a favorite, be sure to look in the mirror during the onset/peak of effects to see how large your pupils have gotten. Typical user reaction: COOOOL! Pupils remain light-responsive (they will contract in the presence of bright light.) Still, if one planned to use MDMA while out in sunlight, a pair of sunglasses wouldn’t be a bad idea.

• Nystagmus. A big word for a small symptom: Your field of vision ‘jumping’ slightly from side to side due to twitches of the muscles that control eye movement (sometimes called ‘eye wiggles’.) Sometimes this effect is obvious, but for many people to notice it you’ll need to relax and just sort of stare off into space. It’s not clear what causes it, but it may be the result of MDMA’s affect on the sense of balance (you can also see nystagmus is people with inner ear problems.) When it does detectably occur, it’s usually not troublesome: Users tend to describe it as ‘cool’ or ‘weird’.

• Minor visual effects. You may see faint ‘halos’ around lights, tracers from lights, and subtle changes to textures. Much of this may be simply due to pupil dilation. I haven’t heard anybody complain about these effects–they’re often not even noticeable. Note: In rare individuals or at very high doses of MDMA well-formed visual effects have been reported (seeing literal faces in clouds, etc.) As in virtually all cases of drug-induced visuals, the user is unlikely to believe what they are seeing is anything but a curious side-effect of the drug. Personally, I’ve never seen such a thing. Most cases of “MDMA visuals” are probably actually due to MDA, which is very similar to MDMA and is sold as ‘ecstasy’ with some regularity.

• Bruxism. An unpleasent side effect, bruxism is clenching your teeth (and in some cases, grinding them) and is a very common side effect of stimulant drugs (including MDMA.) The result can be jaw/tooth pain, bitten cheeks, and in some extreme cases damage to teeth or dental work. Bruxism is mainly seen during the latter part of the ‘high’, and can be dealt with in a number of ways.

One of the more colorful solutions has been baby pacifiers, which eventually became something of a fashion statement even among non-users at raves. A pacifier works because the contraction of the jaw muscles actually is under control…the problem is that you don’t notice when you start to clench because your back teeth are built to take pressure and won’t complain until they start to hurt. Putting something between your front teeth lets you know when your jaw starts to close, allowing you to stop the gesture.

An easy solution that doesn’t make you look like you’re reverting to infancy is simply to press the tip of your tongue against your front teeth (so it’s slightly between the upper and lower teeth. No, you won’t bite it off…your brain will interrupt the ‘bite’ gesture when it notices pressure on your tongue. Other popular ways to deal with the tendency to clench your teeth include hard candies and gum.

Last but not least, a number of users have reported that taking magnesium supplements reduces clenching. I haven’t tried it myself, but the idea makes some theoretical sense. (Mg++ ions reduce some ion channels permeability to Ca++ ions. If you have no idea what that means, don’t worry…just try it and see if it helps.)

• Digestive upset. That’s a nice way of saying you might feel queasy, throw up, or have to run to the bathroom quickly. Throwing up is unusual but somewhat common (and usually associated with high doses, stomach unfriendly foods (fatty/spicy) or drinking large amounts of water.) This isn’t a surprising effect since MDMA causes the release of serotonin, and serotonin enhances the contraction of smooth muscle. Trouble is, your digestive tract is lined with smooth muscle, and if it starts to contract a little too vigorously… Once the drug properly takes effect any nausea, etc. should go away; these are almost exclusively problems seen during the onset.

• Difficulty urinating. One of the more amusing side effects if it’s not happening to you. MDMA (and many related drugs) promote muscle contraction. In order to pee, you need to relax a muscle controlling urine flow. You can imagine the problem. This isn’t a major issue for most people, and shouldn’t require more radical measures than taking your time and letting yourself relax. One of the more clever suggestions I’ve heard is to do multiplication tables in your head (if that won’t bore and distract you, nothing will.) I’ve tried a form of it, and sure enough it worked! (I just double numbers, i.e. 2 x 2 is 4, 4 x 2 is 8, 8 x 2 is 16, etc.) Since MDMA also temporarily reduces the rate of urine production (it’s an “anti-diuretic”) this is more of an issue immediately following the ‘high’ than during it.

• Impotence. This one is closely related to the last: In order to get an erection, you need to relax, and MDMA rather strongly interferes with that. The effect is only temporary, and will end when the drug is out of your system. Men may also experience difficulty in reaching orgasm. Women don’t seem to suffer from this problem.

• Being ‘off balance.’

At higher doses, MDMA can interfere with your sense of balance/coordination.. As you might guess from the popularity of dancing on MDMA this isn’t a major issue…but something you may notice. The effect is strongest early on, then fades.

• Short attention span/memory.

Under the influence of MDMA, your mind can switch topics rather quickly and completely. You may decide to get something from another room, go there, and then not be able to remember what it was you were looking for because you starting thinking about something else. This isn’t amnesia in the usual sense, just a complete loss of focus on what you were doing when something else comes up.

• Cardiovascular effects.

MDMA is a moderately strong stimulant, and will temporarily increase your blood pressure and heart rate. In human experiments, a moderate dose of MDMA (1.5 mg/kg) increased blood pressure by an average of 25 mm (systolic) and 7 mm (diastolic), so if your blood pressure is normally 120/70, on MDMA you might have a blood pressure of 145/77. In the same experiment, pulse increased by an average of 28 beats per minute.

Taken orally, MDMA usually noticeably takes effect in about 30-45 minutes. That’s not set in stone, though…in some cases you may start to feel high in as little as 20 minutes, or it may take an hour or more. (Depending on dosage, your metabolism, if you took it with food, etc.) For first time users, it’s not unusual for it to take over an hour to take effect due to mild anxiety suppressing its effects; a common mistake of first-timers is to assume that after 45-60 minutes without anything obvious happening that they didn’t take enough, causing them to (often unnecessarily) take more. Be patient.

Typically, the first signs that the drug is taking effect with be a feeling of light-headedness, tingling skin, sometimes feeling warm or chilled.

The major desirable effects (feeling good and energetic) usually last for about 3-5 hours, depending on dose. After that, you’ll feel tired and probably will just want to relax and unwind. You probably won’t feel like eating and will be tired for a day or two afterwards. (More on this in the Hangover section.)

This graph of intoxication levels over a period of eight hours is the result of human experiments with MDMA.[1] The top line is from a dose of 1.5 mg/kg, the middle line is from 0.5 mg/kg, and the bottom is from controls (no drugs). In spite of the popular user impression, there’s not really a clean ‘start’ or ‘stop’ point in this (or other) drug experiences. People reach a point where they decide they’re sufficiently affected to be ‘high’ and call it the onset point; when they later reach a level of drug effects where they feel more sober than high they say they’re ‘down’ (but are still being effected for a while.) To the user, it often feels like the drug climbs in strength very rapidly once onset begins, which at high doses or in especially nervous users can produce a sense of being overwhelmed; this is the main period of vulnerability to a panic attack, when the user may ‘chicken out’ and try to fight the drug’s effects. Relax, let go, and enjoy the ride.

Overheating and hydration issues.

It’s covered in Science, but it’s important that I’ll repeat it here. Ravers are often very concerned about water intake because if you’re going to dance enthusiastically for hours strait, you may get dehydrated, and if you get dehydrated, you’re at a considerably greater risk of heatstroke. If you are not out dancing (or otherwise vigorously exercising) you can ignore water. Just drink normally when you feel thirsty.

If you are being very active and sweating a lot for a prolonged period of time, sports medicine experts suggest about a liter of fluids per hour. The most important advice in avoiding heatstroke and related problems is probably simply to avoid hot environments if you’re going to be active. A good rave/dance club is cool and has good air flow.

Moderate water intake treats dehydration from dancing. That’s it. It’s not an antidote to MDMA, nor is dehydration a real problem with MDMA in the absence of prolonged heavy exercise. Drink a little, but don’t worry about it either way if you aren’t dancing.

Got a Plan?

So, what’s your goal? What you want from MDMA will affect how much you’ll want to take, where to use, etc.

• If you aren’t an experienced user and just want to try it out and see what it’s like, you may be happiest with a low dose at home with a good friend (or two or ten or however many want to join in.) In later experiences (once you’re familiar with its effects) you can increase dose or try more stimulation-rich environments if desired.

• If you want to pursue therapeutic uses, I’d go with a moderate dose in an environment that feels safe and comfortable to you, either by yourself or (ideally) with somebody who is compassionate and aware of your goals (what problems you want to address.) Ideally this would be a psychiatrist or other counselor.

• If the goal is to party and have a wild night out, you’ll need to plan when to take it. If you’re going to dose at home then head out you must have a designated driver or other transportation plans that aren’t dependent on your sobriety. Yes, you usually have around 30-45 minutes until full effects…but it could also take as little as 20 minutes, and there appear to be minor effects even before you actually feel ‘high’. You really don’t want to be behind the wheel when it kicks in. Likewise, have a plan for getting home. When you come down, you’ll probably be tired and distracted…it’s best if somebody else drives you home.

How does the environment affect MDMA? Is a rave really that different from home use?

Yes! How ‘high’ you get depends (more or less) on the amount of serotonin and other neurotransmitters released. MDMA will release some serotonin, but your brain will also release additional serotonin in response to external stimulation. What that means is that if you use MDMA in a ‘positive’ environment (good company, music, lights, etc.) your brain will ramp up the drug’s effects even higher by releasing more serotonin than MDMA alone can.

Because of this interplay between drug and environment, you have a great deal of control over the experience based on your choices. If you want to go sit in a dark quiet room, you can have a perfectly boring, pointless experience. On the other hand, given a stimulating, comfortable environment the same dose of MDMA can produce a very powerful and rich experience. Home use is fine (and the best place to start if you aren’t entirely comfortable with the idea of mind-altering drugs), but I recommend having company or, failing that, at least some good music.

Warning: If you’re out dancing, avoid hot, crowded clubs and take short breaks (just a minute here and there is helpful to avoid overheating.)

Whether the rave environment would appeal to you is a personal call. The best raves are usually small, not very publicly promoted (you need to know people) and involve a lot of illegal drugs but little or no alcohol. That alcohol availability is considered a bad thing is probably a surprise to the average ‘party hard’ type, but it’s absolutely true. You might think that two groups using drugs that make them cheerful and sociable would be a natural mesh, but in spite of the surface similarities, alcohol and MDMA are very different creatures. Not to put too fine a point on it, drunk people are morons. They’re loud, stupid, horny, and can easily become combative…almost the exact opposite of somebody on MDMA. Ironically, the alcohol industry has been one of the most outspoken anti-MDMA groups, even backing anti-MDMA legislation. Their motivation isn’t surprising: People on MDMA drink less alcohol (or not at all.) When MDMA use goes up, booze sales fall. Given the higher rate of death, injury, addiction, violent crime, etc. associated with alcohol vs. MDMA use, you would think that the governments would at least tolerate this shift. (Visit Risks and Prohibition for more info.)

Dosage and Methods of Use

How much MDMA should you take?

That depends on your body weight (and to a lesser degree, your sex.) From a technical standpoint, the typical dosage range is about 1-2 mg/kg. What that means is that if you weigh 100 kg (220 pounds) you would want to take from 100-200 mg of MDMA. (If you’re used to working in terms of pounds, divide by 2.2 to get weight in kilograms.)

If calculations give you brain freeze, a more practical approach is “one or two average (100 mg of MDMA) pills per 220 pounds of body weight.” So, if you weigh around 220 pounds one average pill should give a mild pleasant buzz, while two may give a hell of a ride. A small person (say, 100 pounds) of course should take less…they may get acceptable results with only half a pill. (This is based on an assumption that an average pill contains about 100 mg of MDMA…some pills are much stronger!)

Women are also affected a little differently than men at the same dose (per weight). They experience stronger subjective effects (how ‘high’ they feel) but have smaller increases in blood pressure/pulse. If you’re female, you may want to start out at the lower end of the dosage range and see how it affects you before pushing things higher.

A few words on patterns of use:

It’s best to only take a single dose of MDMA in an evening. Many people will take more when they start to ‘come down’ off the first dose. This practice may or may not be safe. It seems likely that multiple dosing like this will increase the risk of overheating as dopamine levels steadily rise and the dopamine suppressing effects of serotonin are reduced by decreasing serotonin levels. Although a lot of people are obviously doing this without obvious ill effects, in the absence of further research I’m not ready to endorse multiple dosing as safe.

A less common approach to extending an MDMA experience has been used and recommended by therapists: At about the one hour point, an additional small dose can be given to extend the experience by about another hour. Traditionally this has meant perhaps a 40 mg ‘booster’ dose given to a patient who is about an hour into the effects from a 120 mg dose. This is certainly safer than taking additional full doses, but will still make side effects slightly worse.

Can MDMA be taken in ways other than orally?

You can use a drug any way that will get it into you system. In my opinion, MDMA is by far best suited for oral use.

• Variations on oral use: Users have come up with some creative ways to ingest MDMA besides just swallowing the pills. In one approach called parachuting the pill is crushed up and twisted into a piece of tissue paper and swallowed. The idea is simply that the crushed pill will dissolve more quickly than a whole pill, causing a more rapid, stronger onset. Another approach is to dissolve the pill (crushing it first will speed up the process) in liquid and drink it. MDMA has a strong bitter taste, but can be made reasonably palatable by using orange juice, soda, or other beverage as the liquid. Some truly hardy users will chew the pills or hold them under their tongue, again in an attempt to speed the dissolving of the pill and the onset of effects. It’s not clear if any of these methods really make a large difference. More recently, licking a finger and dipping it into a bag of MDMA powder (the original meaning of ‘molly’) and then licking it off your finger has become popular. Ideally you would weigh out a dose of MDMA crystals, but very few people have scales that sensitive.

• Snorting: Insufflation (‘snorting’) enjoys some popularity. Since MDMA is actually a salt (MDMA hydrochloride) it’s going to burn your sinuses like a sonofabitch. If you don’t mind the burn, the dripping sinuses, and the nasty taste in the back of your throat, snorting MDMA can make the onset of effects faster as well as increasing the strength of a given dose. Ideally, one would have pure MDMA powder for this use, but not everyone can find it. Snorting crushed up pills shouldn’t be noteably more harmful, although you’ll get a good deal more crap up in your sinuses (pill binders, etc.) that way.

• Injecting: There are very few reports on the use of MDMA through injection. One of these reports is a coroner’s case study (the user having been killed in the process.) The few times I’ve heard from users who have tried injecting the effects were described as ‘harsh, too speedy…overwhelming.’ Injecting also carries inherent risks of infection and spreading disease. Crushed up pills should never be injected, regardless of the drug: Relatively insoluble binders in the pills may block small blood vessels, causing localized tissue death. People have lost arms to gangrene this way (injecting crushed up pills.) The decision is yours, but if you decide to pursue this route, be extremely careful and start with very low doses, since injecting a drug will deliver a much larger portion of it to your brain much more quickly. The vast Erowid Experience Vaults don’t have even a single instance of injecting MDMA, so this approach is clearly very rare.

• ‘Plugging’: If you have the courage and the inclination, sticking a pill/capsule or suppository of MDMA up your rear end is an option. Users who have tried this route report a better ‘quality’ of onset with less stomach upset. Why would anybody do such a thing? Well, most people wouldn’t. But if you have stomach problems, can’t stand taking pills, or just have too much time on your hands it’s a perfectly legitimate option. (Rectal drug administration is sometimes used in hospitals; it’s just not a common home approach.) A description of one approach can be read at Erowid. Latex gloves and some lubricant are recommenced.

• Transdermal: Perhaps the rarest beast of all, one user has reported using an unusual solvent to transport MDMA through the skin. Details have not been made public.

• Smoking: A few reports of mixed results. The freebase form would be more suitable for smoking.

Drug mixing

It’s fairly common for people to take more than one drug in an evening. Some combinations are potentially dangerous, others can just give unexpected results. Some possible combinations and concerns:

Amphetamines (speed, meth, etc.)

Mixing MDMA with other amphetamines increases the risk of heatstroke, hypertension, heart attack and death. Mixing amphetamines may also increase the risk of neurotoxicity, which is highly dependant on overheating to occur. The combination is best avoided.

Alcohol (and other sedatives such as GHB, Xanax, etc.)

Sedatives can greatly increase the degree of intoxication while making the user less aware of it. Large amounts of alcohol mixed with MDMA can produce bizarre behavior with no memory of it the next day. Mixing stimulants and depressants can allow the user to unwittingly take dangerously large amounts of either since they counteract each other’s effects. There have been some unexplained deaths involving mixing alcohol and MDMA. Most people that end up in the emergency room after using MDMA were mixing it with alcohol.

Many people enjoy the combination, but if you chose to use alcohol with MDMA, do so with moderation. Getting raging drunk and then dropping a few pills is reckless and the gods of natural selection may punish you for it.

Sedatives can be very useful to ‘take the edge off’ after coming down off MDMA.

Cannabis (marijuana) and hashish

Many MDMA users enjoy this combination, but not necessarily at the same time. A small amount of pot before taking MDMA may reduce nausea and anxiety (if the user isn’t entirely comfortable with using MDMA). If used simultaneously the two drugs may not mix well and/or interfere with each other. Smoking a large amount of pot while high on MDMA can be counterproductive and unpleasant.

The combination is believed to be safe, but it may be best to go with one or the other at a given moment in time (you may not enjoy the combination.) Many pot smokers report that it’s a pleasant way to relax after coming down from MDMA.

LSD

The combination of LSD and MDMA is popularly called “candyflipping.” Beware: These drugs are synergistic (a small amount of MDMA and a small amount of LSD can have a strong effect when taken together.)

Not known to be particularly dangerous, but watch the dosage or you may have a stronger trip than you planned.

Psilocybin ("Magic Mushrooms")

Called “Hippieflipping”, effects might be amplified by mixing with MDMA (like LSD.)

Generally believed to be safe, but be careful with dosages; you might get hit harder than you expect!

Cocaine

At first glance it seems obvious that cocaine would pose the same dangers as amphetamine. However, cocaine aggressively competes with MDMA for access to the neurotransmitter transport proteins, and in doing so may actually blunt the MDMA high.

Interaction risks are unclear, but there have been a fair number of deaths involving MDMA and cocaine mixing. The combination should be avoided.

Heroin and other opiates (Oxycodone, etc.)

Anecdotal reports are rare and mixed. Some users liked the combination, some report that it’s very unpleasant and disturbing. There have been disturbing reports of a trend towards using heroin to deal with residual stimulant effects after the MDMA high passes.

The general idea of mixing stimulants and sedatives strikes me as odd: Did you want to be down or up? Safety unclear, but like cocaine there are a good number of deaths involving the combination. Opiates can be highly addictive.

Ready to Roll?

Well, are you ready? A final checklist:

• Are you rested, relaxed, and reasonably healthy?

• Have you tested your pills for contents or otherwise researched what you have?

• Have you decided how much you will take, and whether or not to take a supplemental dose?

• Do you know where you’ll be going/what you’ll be doing, and have a safe plan for getting around?

• Are you comfortable with the idea of getting high? MDMA is very friendly and benign, but if you’re scared to death of altering your mental state for a few hours, you can create problems.

‘Rolling Tricks’:

MDMA can greatly enhance physical and other sensations, which has led users to seek out interesting things to do to take advantage of this effect. Generally, anything that is pleasurable or produces a strong sensory input will become that much more remarkable under the influence of MDMA. A short list of popular items:

• Vicks Vapor-rub. Beyond the skin tingling effect, many people enjoy inhaling the vapors for their bronchiodilating effect.

• ‘Light shows’. Get a bunch of glowsticks and wave ’em around. MDMA enhances the aesthetic appreciation of simple sensory pleasures and tends to produce a minor ‘time lapse photography’ effect, where a quickly moving light produces solid trails of light in the air.

Some other activities:

• Dance, dammit. Humans were meant to dance. Put on some good music and let it guide you, whether in groups or even just by yourself. Since the dawn of our species, we have danced to music beneath the stars; reclaim your humanity and rediscover one of the most primal expressions of the joy of being alive.

• Prayer/meditation. Use whatever form you think might please your god or the universe. For a simple meditative exercise, just sit down, legs crossed, back straight, hands folded in your lap. Slowly and deeply breath in and out, concentrating on your breathing.

• Sing along to music. At the very least, having some good tunes to listen to is mandatory for a hedonistically intentioned roll. Techno is particularly suitable with its fast beats and undemanding, often uplifting themes, but anything you enjoy sober can be even more enjoyable under the influence.

• Water. Showers, baths, swimming pools even. Baths and hot tubs need to be approached with caution, since you will be less aware of any overheating…limit time in a hot tub to a few minutes at the most. Don’t drown yourself in the pool, but once the drug has taken full effect and you’ve gauged your degree of impairment, it’s a definite possibility. (Unlike with alcohol, people on MDMA usually have a high degree of awareness of their own level of intoxication, thanks to MDMA being primarily a stimulant instead of a sedative.)

• Go for a walk. Physical activity/exercise is very complimentary to MDMA, perhaps due to an additional release of endorphins from it.

What not to do:

• Resist the urge to call up people you know and tell them you love them.